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Gamma Knife Radiosurgery

Whole-procedural Radiological Accuracy for Delivering Multi-session Gamma Knife Radiosurgery With a Relocatable Frame System (403-408)

A newly developed Gamma Knife relocatable eXtend frame system has enabled the delivery of multi-session Gamma Knife radiosurgery without the use of skull pin fixation frame system. In this study, we investigate and report for the first time the whole procedural radiological accuracy for administering such treatments. To quantify the radiological alignment, the commonly used Winston-Lutz test was modified and used to determine the device accuracy of the eXtend frame system. Patient setup uncertainties relative to the device were further measured for a series of treatment sessions (n = 58), and then incorporated with the Winston-Lutz test results from individual patient-specific eXtend frame systems. The whole-procedure mean 3D radiological setup uncertainty was determined to be 0.69 ± 0.73 mm (1σ) from all the cases analyzed, and the mean 90% confidence level margins were found to be 0.55, 0.78 and 0.72 mm along the x-, y-, and z-axis, respectively. Our results therefore demonstrated that sub-millimetric radiological accuracy is clinically achievable for multi-session Gamma Knife radiosurgery treatments and a 1 mm margin along the major axes is sufficient for planning multi-session Gamma Knife radiosurgery treatments.

Key words: Stereotactic radiosurgery; Gamma Knife; eXtend System; Relocatable frame; Accuracy.




This article can be cited as:
Ma, L., Pinnaduwage, D., McDermott, M., Sneed, P.K. Whole-procedural Radiological Accuracy for Delivering Multi-session Gamma Knife Radiosurgery With a Relocatable Frame System. Technol Cancer Res Treat. 13, 403-408 (2014) DOI: 10.7785/tcrtexpress.2013.600259

References

1. Sayer FT, Sherman JH, Yen CP, Schlesinger DJ, Kersh R & Sheehan JP. Initial experience with the eXtend System: a relocatable frame system for multiple-session gamma knife radiosurgery. World Neurosurg 75, 665-672 (2011). [Crossref] http://www.ncbi.nlm.nih.gov/pubmed/21704934
2. Lindquist C & Paddick I. The Leksell Gamma Knife Perfexion and comparisons with its predecessors. Neurosurgery 61, 130-140; discussion 140-131 (2007). [Crossref]. 8a00006123-200709001-00022 [pii]. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd5Retrieve&db5PubMed&dopt5Citation& list_uids517876243
3. Novotny J, Bhatnagar JP, Niranjan A, Quader MA, Huq MS, Bednarz G, Flickinger JC, Kondziolka D & Lunsford LD. Dosimetric comparison of the Leksell Gamma Knife perfexion and 4C. J Neurosurg 109(Suppl), 8-14 (2008). [Crossref]. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd5Retrieve& db5PubMed&dopt5Citation&list_uids519123882
4. Regis J, Tamura M, Guillot C, Yomo S, Muraciolle X, Nagaje M, Arka Y & Porcheron D. Radiosurgery with the world’s first fully robotized Leksell Gamma Knife Perfexion in clinical use: a 200-patient prospective, randomized, controlled comparison with the Gamma Knife 4C. Neurosurgery 64, 346-355; discussion 355-346 (2009). [Crossref] [pii]. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd5 Retrieve&db5PubMed&dopt5Citation&list_uids519190462
5. Sahgal A, Ma L, Chang E, Shiu A, Larson DA, Laperriere N, Yin FF, Tsao M, Menard C, Basran PS, Letourneau D, Heydarian M, Beachey D, Shukla V, Cusimano M, Hodaie M, Zadeh G, Bernstein M & Schwartz M. Advances in technology for intracranial stereotactic radiosurgery. Technol Cancer Res Treat 8, 271-280 (2009). [Crossref] [pii]. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd5Retrieve&db5PubMed& dopt5Citation&list_uids519645520
6. Ruschin M, Nayebi N, Carlsson P, Brown K, Tamerou M, Li W, Laperriere N, Sahgal A, Cho YB, Menard C & Jaffray D. Performance of a novel repositioning head frame for gamma knife perfexion and image-guided linac-based intracranial stereotactic radiotherapy. International Journal of Radiation Oncology, Biology, Physics 78, 306-313 (2010). [Crossref]. http://www.ncbi.nlm.nih.gov/pubmed/20385456
7. Ma L, Chuang C, Descovich M, Petti P, Smith V & Verhey L. Whole-procedure clinical accuracy of gamma knife treatments of large lesions. Med Phys 35, 5110-5114 (2008). [Crossref]. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd5Retrieve&db5PubMed&dopt5Citation&list_uids519070245
8. Schlesinger D, Xu Z, Taylor F, Yen CP & Sheehan J. Interfraction and intrafraction performance of the Gamma Knife Extend system for patient positioning and immobilization. Journal of Neurosurgery 117(Suppl), 217-224 (2012). [Crossref]. http://www.ncbi.nlm.nih.gov/pubmed/23205813
9. Ma L, Sahgal A, Descovich M, Cho YB, Chuang C, Huang K, Laperriere NJ, Shrieve DC & Larson DA. Equivalence in dose fall-off for isocentric and nonisocentric intracranial treatment modalities and its impact on dose fractionation schemes. International Journal of Radiation Oncology, Biology, Physics 76, 943-948 (2010). [Crossref]. http://www.ncbi.nlm.nih.gov/pubmed/20159366
10. Lutz W, Winston KR & Maleki N. A system for stereotactic radiosurgery with a linear accelerator. International Journal of Radiation Oncology, Biology, Physics 14, 373-381 (1988). [Crossref]. http://www.ncbi.nlm.nih.gov/pubmed/3276655
11. Yoda K & Nakagawa K. Technical note: Extension of Van Herk’s treatment margin model for anisotropic systematic positioning errors in cartesian coordinate systema. Medical Physics 38, 3913-3914 (2011). [Crossref]. http://www.ncbi.nlm.nih.gov/pubmed/21858987
12. van Herk M. Errors and margins in radiotherapy. Seminars in Radiation Oncology 14, 52-64 (2004). [Crossref]. http://www.ncbi.nlm.nih.gov/pubmed/14752733

This article can be accessed at PubMed:
http://www.ncbi.nlm.nih.gov/pubmed/24000986

Received: January 22, 2013; Revised; March, 9 2013; Accepted: March 11, 2013; Published in TCRT Express on: April 02 2013

TCRT October 2014

category image
Volume 13
No. 5 (386-484)
October 2014
ISSN 1533-0338

DOI: 10.7785/tcrtexpress.2013.600259

Lijun Ma, Ph.D.1*
Dilini Pinnaduwage, Ph.D.1
Michael McDermott, M.D.2
Penny K. Sneed, M.D.1

1Department of Radiation Oncology, University of California, San Francisco, CA 94143
2Department of Neurosurgery, University of California, San Francisco, CA 94143

Open Access Article
The authors, the publisher, and the right holders grant the right to use, reproduce, and disseminate the work in digital form to all users.


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*Corresponding author: Professor Lijun Ma, Ph.D.
Phone: 415-353-8932
Fax: 415-353-8679
E-mail: lijunma@radonc.ucsf.edu